Ecthyma gangrenosum in a premature infant: rare but critical to recognise

A premature male infant born at 26+1 weeks of gestation, with a birth weight of 615 g (<p1), was admitted to the neonatal intensive care unit. In the absence of risk factors, no antibiotics were started initially. Directly after birth, neutropenia (0.9x109/L) was noted, most likely explained by dysmaturity. On day 3, he showed symptoms of infection, including hypotension and a necrotic ulcer in the right armpit (figure 1). Laboratory testing revealed an elevated C reactive protein (CRP) and persistent neutropenia. Antibiotic treatment was started after obtaining a blood culture, which showed no growth. A swab of the ulcus, however, showed Pseudomonas aeruginosa, supporting the diagnosis ecthyma gangrenosum (EG). Initially, the infant clinically improved. After 6 days of treatment, the CRP level increased again and sputum culture tested positive for P. aeruginosa. After removing all foreign material including the endotracheal tube, the CRP normalised, and after a total of...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - Category: Perinatology & Neonatology Authors: Tags: Images in neonatal medicine Source Type: research